BC-Health-of-the-Homeless-Survey-FINAL[1] - Pacific AIDS Network


BC-Health-of-the-Homeless-Survey-FINAL[1] - Pacific AIDS Network

Table 8: Smoking behavior and nicotine dependence among participants who reported

smoking (n=404)

Variables n (%)

Non-smokers 96 (19.2)


low dependence

high dependence

Cigarettes smoked per day

1 - 10

11 - 20

21 - 30

31 and more

Nicotine dependence scores (FTND)

0 - 2 (very low)

3 - 4 (low)

5 (medium)

6 - 7 (high)

8 - 10 (very high)

FTND = Fagerstrom Test for Nicotine Dependence

404 (80.8)

197 (39.4)

207 (41.1)

138 (34.2)

161 (39.8)

85 (21.0)

20 (5.0)

60 (14.8)

71 (17.6)

66 (16.3)

130 (32.2)

77 (19.1)

Our participants had high nicotine dependence with an

average FTND score of 5.0. In comparison, the average

FTND scores in different samples of the general population

from twelve European countries and the US ranged from

2.8 to 4.6 (119). Given that high nicotine dependence

is associated with low quit attempts and cessation failure

(120), our participants may need more support for smoking

cessation. Among homeless service providers, tobacco is often

regarded as a resource or at least a minor problem compared

to other challenges homeless people face (121). Furthermore,

public-health tobacco control strategies are not targeted to the

homeless population, and homeless individuals do not have

access to pharmacological and psychosocial smoking cessation

interventions. However, if Canada is to sustain the reduction

in tobacco use and decrease smoking prevalence rates in the

Canadian population as outlined in their National Tobacco

Control Strategy (122), marginalized and underserved

populations including the homeless have to be addressed.

Immediate recommendations

Although there are many treatments available for tobacco dependence, they require a stable client.

Treatments for tobacco dependence that require little commitment to a program would be ideal for a

transient population such as the homeless and should be made more available. Education regarding the

harms of smoking and the benefits of smoking cessation should be provided to both homeless individuals

who smoke and homeless service providers. In addition, available public health tobacco dependence

treatment opportunities and free tobacco dependence medications should be made available within all

settings, which care for the homeless.

28 | BC Health of the Homeless Survey

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